uds follow-up visit packet, v1.2, 2006sep. · nacc uds follow-up visit packet (version 1.2, sep....

NACC UDS Follow-up Visit Packet (version 1.2, March 2006) Data Template – 1

4311 11th Avenue NE #300 Seattle, WA 98105 phone: (206) 543-8637; fax: (206) 616-5927e-mail: [email protected] website: https://www.alz.washington.edu

Department of Epidemiology, School of Public Health and Community Medicine, University of Washington

NACC Uniform Data Set (UDS) Follow-up Visit Packet

Data Template

(Version 1.2, March 2006)

NOTE: Version 1.2 is NOT the most current version of the UDS forms and is no longer used for data submission. For the most current version, please visit

http://www.alz.washington.edu.

NACC UDS Follow-up Visit Packet (version 1.2, Sep. 2006) Data Template – 1

Data Template Uniform Data Set (UDS) – Follow-up Visit Packet

This template is designed to assist the Centers that choose to upload UDS data in batch format. The template details the data element names, type of data element, columns for ASCII file submission, and item number.

This template is only needed for ASCII batch file submissions. Centers using web data entry will not need this template.

A more detailed description of each data element is found in the Data Element Dictionary. Data elements are listed by form and by item number within form.

1. The first 10 data elements, which are shaded on the template, are required. They must have legal values or the form cannot be processed.

2. There is exactly one blank space required between the data fields of adjacent variables. Although a data field may in some cases contain one or more blanks, the required separator blank must still be included. Column assignments and column alignment must be maintained.

3. In some cases, the item number in the template does not appear on the form. This is true for most “Other (specify)” text items and dates.

4. In the future, there may be more than one version of a form in current use; make sure you are using the appropriate template.

Form Header Coding (first 10 data elements) PACKET = F (for Follow-up Visit Packet)

FORMID = Form ID (i.e., Z1, A1, B4, etc.)

FORMVER = 1

ADCID = Center ID (same number used in the MDS and NP data for your Center; see the UDS Data Element Dictionary for a list of Center IDs)

PTID = Patient ID (same PTID assigned to the subject for the Initial Visit Packet)

VISITMO VISITDAY = Actual date of the interview VISITYR

VISITNUM = Visit ID (assigned by your Center; need not start with 1)

INITIALS = Examiner initials (initials of the person conducting the interview)

Packet F, Form Z1: FORM CHECKLIST (Version 1) Variable length Columns Variable Name

Character or Numeric Item #


2 1-2 PACKET C 3 4-6 FORMID C 3 8-10 FORMVER N 2 12-13 ADCID N

10 15-24 PTID C 2 26-27 VISITMO N 2 29-30 VISITDAY N 4 32-35 VISITYR N 3 37-39 VISITNUM C 3 41-43 INITIALS C

1 45 A2SUB N 1

2 47-48 A2NOT N 1A

60 50-109 A2COMM C 1B

1 111 A3SUB N 2

2 113-114 A3NOT N 2A

60 116-175 A3COMM C 2B

1 177 A4SUB N 3

2 179-180 A4NOT N 3A

60 182-241 A4COMM C 3B

1 243 B1SUB N 4

2 245-246 B1NOT N 4A

60 248-307 B1COMM C 4B

1 309 B2SUB N 5

2 311-312 B2NOT N 5A

60 314-373 B2COMM C 5B

1 375 B3SUB N 6

2 377-378 B3NOT N 6A

60 380-439 B3COMM C 6B

1 441 B5SUB N 7

2 443-444 B5NOT N 7A

60 446-505 B5COMM C 7B

1 507 B6SUB N 8

2 509-510 B6NOT N 8A

60 512-571 B6COMM C 8B

1 573 B7SUB N 9

2 575-576 B7NOT N 9A

60 578-637 B7COMM C 9B

Packet F, Form Z1: FORM CHECKLIST (Version 1) Variable length Columns Variable Name



1 639 B8SUB N 10

2 641-642 B8NOT N 10A

60 644-703 B8COMM C 10B

Packet F, Form A1: SUBJECT DEMOGRAPHICS (Version 1) Variable length Columns Variable Name





2 45-46 BIRTHMO N 1A

4 48-51 BIRTHYR N 1B

1 53 SEX N 2

1 55 LIVSIT N 3

60 57-116 LIVSITX C 3A

1 118 INDEPEND N 4

1 120 RESIDENC N 5

60 122-181 RESIDENX C 5A

3 183-185 ZIP C 6

1 187 MARISTAT N 7

60 189-248 MARISTAX C 7A

Packet F, Form A2: INFORMANT DEMOGRAPHICS (Version 1) Variable length Columns Variable Name





2 45-46 INBIRMO N 1A

4 48-51 INBIRYR N 1B

1 53 INSEX N 2

1 55 NEWINF N 3

1 57 INHISP N 4A

2 59-60 INHISPOR N 4B

60 62-121 INHISPORX C 4B1

2 123-124 INRACE N 5

60 126-185 INRACEX C 5A

2 187-188 INRASEC N 6

60 190-249 INRASECX C 6A

2 251-252 INRATER N 7

60 254-313 INRATERX C 7A

2 315-316 INEDUC N 8

1 318 INRELTO N 9

60 320-379 INRELTOX C 9A

1 381 INLIVWTH N 10

1 383 INVISITS N 10A

1 385 INCALLS N 10B

1 387 INRELY N 11

Packet F, Form A3: SUBJECT FAMILY HISTORY (Version 1) Variable length Columns Variable Name





1 45 A3CHG N 0Y

1 47 PARCHG N 0Z

1 49 MOMDEM N 1

3 51-53 MOMONSET N 1A

3 55-57 MOMAGE N 1B

3 59-61 MOMDAGE N 1C

1 63 DADDEM N 2

3 65-67 DADONSET N 2A

3 69-71 DADAGE N 2B

3 73-75 DADDAGE N 2C

1 77 SIBCHG N 2D

1 79 TWIN N 3

1 81 TWINTYPE N 3A

2 83-84 SIBS N 4

2 86-87 SIBSDEM N 5

3 89-91 SIB1ONS N 5A1

3 93-95 SIB1AGE N 5A2

3 97-99 SIB2ONS N 5B1

3 101-103 SIB2AGE N 5B2

3 105-107 SIB3ONS N 5C1

3 109-111 SIB3AGE N 5C2

3 113-115 SIB4ONS N 5D1

3 117-119 SIB4AGE N 5D2

3 121-123 SIB5ONS N 5E1

3 125-127 SIB5AGE N 5E2

3 129-131 SIB6ONS N 5F1

3 133-135 SIB6AGE N 5F2

Packet F, Form A3: SUBJECT FAMILY HISTORY (Version 1) Variable length Columns Variable Name



1 137 KIDCHG N 5G

2 139-140 KIDS N 6

2 142-143 KIDSDEM N 7

3 145-147 KID1ONS N 7A1

3 149-151 KID1AGE N 7A2

3 153-155 KID2ONS N 7B1

3 157-159 KID2AGE N 7B2

3 161-163 KID3ONS N 7C1

3 165-167 KID3AGE N 7C2

3 169-171 KID4ONS N 7D1

3 173-175 KID4AGE N 7D2

3 177-179 KID5ONS N 7E1

3 181-183 KID5AGE N 7E2

3 185-187 KID6ONS N 7F1

3 189-191 KID6AGE N 7F2

1 193 RELCHG N 7G

2 195-196 RELSDEM N 8

3 198-200 REL1ONS N 8A1

3 202-204 REL1AGE N 8A2

3 206-208 REL2ONS N 8B1

3 210-212 REL2AGE N 8B2

3 214-216 REL3ONS N 8C1

3 218-220 REL3AGE N 8C2

3 222-224 REL4ONS N 8D1

3 226-228 REL4AGE N 8D2

3 230-232 REL5ONS N 8E1

3 234-236 REL5AGE N 8E2

3 238-240 REL6ONS N 8F1

3 242-244 REL6AGE N 8F2

Packet F, Form A4: SUBJECT MEDICATIONS (Version 1) Variable length Columns Variable Name





1 45 PMEDS N 1

30 47-76 PMA C 1A

5 78-82 PMAS N 1A1

1 84 PMASU N 1A2

2 86-87 PMAF N 1A3

1 89 PMAFU N 1A4

1 91 PMAP N 1A5

2 93-94 PMAPF N 1A6

1 96 PMAPFU N 1A7

30 98-127 PMB C 1B

5 129-133 PMBS N 1B1

1 135 PMBSU N 1B2

2 137-138 PMBF N 1B3

1 140 PMBFU N 1B4

1 142 PMBP N 1B5

2 144-145 PMBPF N 1B6

1 147 PMBPFU N 1B7

30 149-178 PMC C 1C

5 180-184 PMCS N 1C1

1 186 PMCSU N 1C2

2 188-189 PMCF N 1C3

1 191 PMCFU N 1C4

1 193 PMCP N 1C5

2 195-196 PMCPF N 1C6

1 198 PMCPFU N 1C7

30 200-229 PMD C 1D

5 231-235 PMDS N 1D1




1 237 PMDSU N 1D2

2 239-240 PMDF N 1D3

1 242 PMDFU N 1D4

1 244 PMDP N 1D5

2 246-247 PMDPF N 1D6

1 249 PMDPFU N 1D7

30 251-280 PME C 1E

5 282-286 PMES N 1E1

1 288 PMESU N 1E2

2 290-291 PMEF N 1E3

1 293 PMEFU N 1E4

1 295 PMEP N 1E5

2 297-298 PMEPF N 1E6

1 300 PMEPFU N 1E7

30 302-331 PMF C 1F

5 333-337 PMFS N 1F1

1 339 PMFSU N 1F2

2 341-342 PMFF N 1F3

1 344 PMFFU N 1F4

1 346 PMFP N 1F5

2 348-349 PMFPF N 1F6

1 351 PMFPFU N 1F7

30 353-382 PMG C 1G

5 384-388 PMGS N 1G1

1 390 PMGSU N 1G2

2 392-393 PMGF N 1G3

1 395 PMGFU N 1G4

1 397 PMGP N 1G5

2 399-400 PMGPF N 1G6

1 402 PMGPFU N 1G7

30 404-433 PMH C 1H

5 435-439 PMHS N 1H1

1 441 PMHSU N 1H2

2 443-444 PMHF N 1H3

1 446 PMHFU N 1H4

1 448 PMHP N 1H5




2 450-451 PMHPF N 1H6

1 453 PMHPFU N 1H7

30 455-484 PMI C 1I

5 486-490 PMIS N 1I1

1 492 PMISU N 1I2

2 494-495 PMIF N 1I3

1 497 PMIFU N 1I4

1 499 PMIP N 1I5

2 501-502 PMIPF N 1I6

1 504 PMIPFU N 1I7

30 506-535 PMJ C 1J

5 537-541 PMJS N 1J1

1 543 PMJSU N 1J2

2 545-546 PMJF N 1J3

1 548 PMJFU N 1J4

1 550 PMJP N 1J5

2 552-553 PMJPF N 1J6

1 555 PMJPFU N 1J7

30 557-586 PMK C 1K

5 588-592 PMKS N 1K1

1 594 PMKSU N 1K2

2 596-597 PMKF N 1K3

1 599 PMKFU N 1K4

1 601 PMKP N 1K5

2 603-604 PMKPF N 1K6

1 606 PMKPFU N 1K7

30 608-637 PML C 1L

5 639-643 PMLS N 1L1

1 645 PMLSU N 1L2

2 647-648 PMLF N 1L3

1 650 PMLFU N 1L4

1 652 PMLP N 1L5

2 654-655 PMLPF N 1L6

1 657 PMLPFU N 1L7

30 659-688 PMM C 1M

5 690-694 PMMS N 1M1




1 696 PMMSU N 1M2

2 698-699 PMMF N 1M3

1 701 PMMFU N 1M4

1 703 PMMP N 1M5

2 705-706 PMMPF N 1M6

1 708 PMMPFU N 1M7

30 710-739 PMN C 1N

5 741-745 PMNS N 1N1

1 747 PMNSU N 1N2

2 749-750 PMNF N 1N3

1 752 PMNFU N 1N4

1 754 PMNP N 1N5

2 756-757 PMNPF N 1N6

1 759 PMNPFU N 1N7

30 761-790 PMO C 1O

5 792-796 PMOS N 1O1

1 798 PMOSU N 1O2

2 800-801 PMOF N 1O3

1 803 PMOFU N 1O4

1 805 PMOP N 1O5

2 807-808 PMOPF N 1O6

1 810 PMOPFU N 1O7

30 812-841 PMP C 1P

5 843-847 PMPS N 1P1

1 849 PMPSU N 1P2

2 851-852 PMPF N 1P3

1 854 PMPFU N 1P4

1 856 PMPP N 1P5

2 858-859 PMPPF N 1P6

1 861 PMPPFU N 1P7

30 863-892 PMQ C 1Q

5 894-898 PMQS N 1Q1

1 900 PMQSU N 1Q2

2 902-903 PMQF N 1Q3

1 905 PMQFU N 1Q4

1 907 PMQP N 1Q5




2 909-910 PMQPF N 1Q6

1 912 PMQPFU N 1Q7

30 914-943 PMR C 1R

5 945-949 PMRS N 1R1

1 951 PMRSU N 1R2

2 953-954 PMRF N 1R3

1 956 PMRFU N 1R4

1 958 PMRP N 1R5

2 960-961 PMRPF N 1R6

1 963 PMRPFU N 1R7

30 965-994 PMS C 1S

5 996-1000 PMSS N 1S1

1 1002 PMSSU N 1S2

2 1004-1005 PMSF N 1S3

1 1007 PMSFU N 1S4

1 1009 PMSP N 1S5

2 1011-1012 PMSPF N 1S6

1 1014 PMSPFU N 1S7

30 1016-1045 PMT C 1T

5 1047-1051 PMTS N 1T1

1 1053 PMTSU N 1T2

2 1055-1056 PMTF N 1T3

1 1058 PMTFU N 1T4

1 1060 PMTP N 1T5

2 1062-1063 PMTPF N 1T6

1 1065 PMTPFU N 1T7

1 1067 NMEDS N 2

30 1069-1098 NMA C 2A

5 1100-1104 NMAS N 2A1

1 1106 NMASU N 2A2

2 1108-1109 NMAF N 2A3

1 1111 NMAFU N 2A4

30 1113-1142 NMB C 2B

5 1144-1148 NMBS N 2B1

1 1150 NMBSU N 2B2

2 1152-1153 NMBF N 2B3




1 1155 NMBFU N 2B4

30 1157-1186 NMC C 2C

5 1188-1192 NMCS N 2C1

1 1194 NMCSU N 2C2

2 1196-1197 NMCF N 2C3

1 1199 NMCFU N 2C4

30 1201-1230 NMD C 2D

5 1232-1236 NMDS N 2D1

1 1238 NMDSU N 2D2

2 1240-1241 NMDF N 2D3

1 1243 NMDFU N 2D4

30 1245-1274 NME C 2E

5 1276-1280 NMES N 2E1

1 1282 NMESU N 2E2

2 1284-1285 NMEF N 2E3

1 1287 NMEFU N 2E4

30 1289-1318 NMF C 2F

5 1320-1324 NMFS N 2F1

1 1326 NMFSU N 2F2

2 1328-1329 NMFF N 2F3

1 1331 NMFFU N 2F4

30 1333-1362 NMG C 2G

5 1364-1368 NMGS N 2G1

1 1370 NMGSU N 2G2

2 1372-1373 NMGF N 2G3

1 1375 NMGFU N 2G4

30 1377-1406 NMH C 2H

5 1408-1412 NMHS N 2H1

1 1414 NMHSU N 2H2

2 1416-1417 NMHF N 2H3

1 1419 NMHFU N 2H4

30 1421-1450 NMI C 2I

5 1452-1456 NMIS N 2I1

1 1458 NMISU N 2I2

2 1460-1461 NMIF N 2I3

1 1463 NMIFU N 2I4




30 1465-1494 NMJ C 2J

5 1496-1500 NMJS N 2J1

1 1502 NMJSU N 2J2

2 1504-1505 NMJF N 2J3

1 1507 NMJFU N 2J4

30 1509-1538 NMK C 2K

5 1540-1544 NMKS N 2K1

1 1546 NMKSU N 2K2

2 1548-1549 NMKF N 2K3

1 1551 NMKFU N 2K4

30 1553-1582 NML C 2L

5 1584-1588 NMLS N 2L1

1 1590 NMLSU N 2L2

2 1592-1593 NMLF N 2L3

1 1595 NMLFU N 2L4

30 1597-1626 NMM C 2M

5 1628-1632 NMMS N 2M1

1 1634 NMMSU N 2M2

2 1636-1637 NMMF N 2M3

1 1639 NMMFU N 2M4

30 1641-1670 NMN C 2N

5 1672-1676 NMNS N 2N1

1 1678 NMNSU N 2N2

2 1680-1681 NMNF N 2N3

1 1683 NMNFU N 2N4

30 1685-1714 NMO C 2O

5 1716-1720 NMOS N 2O1

1 1722 NMOSU N 2O2

2 1724-1725 NMOF N 2O3

1 1727 NMOFU N 2O4

30 1729-1758 NMP C 2P

5 1760-1764 NMPS N 2P1

1 1766 NMPSU N 2P2

2 1768-1769 NMPF N 2P3

1 1771 NMPFU N 2P4

30 1773-1802 NMQ C 2Q




5 1804-1808 NMQS N 2Q1

1 1810 NMQSU N 2Q2

2 1812-1813 NMQF N 2Q3

1 1815 NMQFU N 2Q4

30 1817-1846 NMR C 2R

5 1848-1852 NMRS N 2R1

1 1854 NMRSU N 2R2

2 1856-1857 NMRF N 2R3

1 1859 NMRFU N 2R4

30 1861-1890 NMS C 2S

5 1892-1896 NMSS N 2S1

1 1898 NMSSU N 2S2

2 1900-1901 NMSF N 2S3

1 1903 NMSFU N 2S4

30 1905-1934 NMT C 2T

5 1936-1940 NMTS N 2T1

1 1942 NMTSU N 2T2

2 1944-1945 NMTF N 2T3

1 1947 NMTFU N 2T4

1 1949 VITASUPS N 3

30 1951-1980 VSA C 3A

5 1982-1986 VSAS N 3A1

1 1988 VSASU N 3A2

2 1990-1991 VSAF N 3A3

1 1993 VSAFU N 3A4

30 1995-2024 VSB C 3B

5 2026-2030 VSBS N 3B1

1 2032 VSBSU N 3B2

2 2034-2035 VSBF N 3B3

1 2037 VSBFU N 3B4

30 2039-2068 VSC C 3C

5 2070-2074 VSCS N 3C1

1 2076 VSCSU N 3C2

2 2078-2079 VSCF N 3C3

1 2081 VSCFU N 3C4

30 2083-2112 VSD C 3D




5 2114-2118 VSDS N 3D1

1 2120 VSDSU N 3D2

2 2122-2123 VSDF N 3D3

1 2125 VSDFU N 3D4

30 2127-2156 VSE C 3E

5 2158-2162 VSES N 3E1

1 2164 VSESU N 3E2

2 2166-2167 VSEF N 3E3

1 2169 VSEFU N 3E4

30 2171-2200 VSF C 3F

5 2202-2206 VSFS N 3F1

1 2208 VSFSU N 3F2

2 2210-2211 VSFF N 3F3

1 2213 VSFFU N 3F4

30 2215-2244 VSG C 3G

5 2246-2250 VSGS N 3G1

1 2252 VSGSU N 3G2

2 2254-2255 VSGF N 3G3

1 2257 VSGFU N 3G4

30 2259-2288 VSH C 3H

5 2290-2294 VSHS N 3H1

1 2296 VSHSU N 3H2

2 2298-2299 VSHF N 3H3

1 2301 VSHFU N 3H4

30 2303-2332 VSI C 3I

5 2334-2338 VSIS N 3I1

1 2340 VSISU N 3I2

2 2342-2343 VSIF N 3I3

1 2345 VSIFU N 3I4

30 2347-2376 VSJ C 3J

5 2378-2382 VSJS N 3J1

1 2384 VSJSU N 3J2

2 2386-2387 VSJF N 3J3

1 2389 VSJFU N 3J4

30 2391-2420 VSK C 3K

5 2422-2426 VSKS N 3K1




1 2428 VSKSU N 3K2

2 2430-2431 VSKF N 3K3

1 2433 VSKFU N 3K4

30 2435-2464 VSL C 3L

5 2466-2470 VSLS N 3L1

1 2472 VSLSU N 3L2

2 2474-2475 VSLF N 3L3

1 2477 VSLFU N 3L4

30 2479-2508 VSM C 3M

5 2510-2514 VSMS N 3M1

1 2516 VSMSU N 3M2

2 2518-2519 VSMF N 3M3

1 2521 VSMFU N 3M4

30 2523-2552 VSN C 3N

5 2554-2558 VSNS N 3N1

1 2560 VSNSU N 3N2

2 2562-2563 VSNF N 3N3

1 2565 VSNFU N 3N4

30 2567-2596 VSO C 3O

5 2598-2602 VSOS N 3O1

1 2604 VSOSU N 3O2

2 2606-2607 VSOF N 3O3

1 2609 VSOFU N 3O4

30 2611-2640 VSP C 3P

5 2642-2646 VSPS N 3P1

1 2648 VSPSU N 3P2

2 2650-2651 VSPF N 3P3

1 2653 VSPFU N 3P4

30 2655-2684 VSQ C 3Q

5 2686-2690 VSQS N 3Q1

1 2692 VSQSU N 3Q2

2 2694-2695 VSQF N 3Q3

1 2697 VSQFU N 3Q4

30 2699-2728 VSR C 3R

5 2730-2734 VSRS N 3R1

1 2736 VSRSU N 3R2




2 2738-2739 VSRF N 3R3

1 2741 VSRFU N 3R4

30 2743-2772 VSS C 3S

5 2774-2778 VSSS N 3S1

1 2780 VSSSU N 3S2

2 2782-2783 VSSF N 3S3

1 2785 VSSFU N 3S4

30 2787-2816 VST C 3T

5 2818-2822 VSTS N 3T1

1 2824 VSTSU N 3T2

2 2826-2827 VSTF N 3T3

1 2829 VSTFU N 3T4

Packet F, Form A5: SUBJECT HEALTH HISTORY (Version 1) Variable length Columns Variable Name





1 45 CVHATT N 1A

1 47 CVAFIB N 1B

1 49 CVANGIO N 1C

1 51 CVBYPASS N 1D

1 53 CVPACE N 1E

1 55 CVCHF N 1F

1 57 CVOTHR N 1G

60 59-118 CVOTHRX C 1G1

1 120 CBSTROKE N 2A

4 122-125 STROK1YR N 2A1

4 127-130 STROK2YR N 2A2

4 132-135 STROK3YR N 2A3

4 137-140 STROK4YR N 2A4

4 142-145 STROK5YR N 2A5

4 147-150 STROK6YR N 2A6

1 152 CBTIA N 2B

4 154-157 TIA1YR N 2B1

4 159-162 TIA2YR N 2B2

4 164-167 TIA3YR N 2B3

4 169-172 TIA4YR N 2B4

4 174-177 TIA5YR N 2B5

4 179-182 TIA6YR N 2B6

1 184 CBOTHR N 2C

60 186-245 CBOTHRX C 2C1

1 247 PD N 3A

4 249-252 PDYR N 3A1

1 254 PDOTHR N 3B

Packet F, Form A5: SUBJECT HEALTH HISTORY (Version 1) Variable length Columns Variable Name



4 256-259 PDOTHRYR N 3B1

1 261 SEIZURES N 4A

1 263 TRAUMBRF N 4B1

1 265 TRAUMEXT N 4B2

1 267 TRAUMCHR N 4B3

1 269 NCOTHR N 4C

60 271-330 NCOTHRX C 4C1

1 332 HYPERTEN N 5A

1 334 HYPERCHO N 5B

1 336 DIABETES N 5C

1 338 B12DEF N 5D

1 340 THYROID N 5E

1 342 INCONTU N 5F

1 344 INCONTF N 5G

1 346 DEP2YRS N 6A

1 348 DEPOTHR N 6B

1 350 ALCOHOL N 7A1

1 352 TOBAC30 N 7B1

1 354 TOBAC100 N 7B2

2 356-357 SMOKYRS N 7B3

1 359 PACKSPER N 7B4

3 361-363 QUITSMOK N 7B5

1 365 ABUSOTHR N 7C1

60 367-426 ABUSX C 7C2

1 428 PSYCDIS N 7D

60 430-489 PSYCDISX C 7D1

Packet F, Form B1: EVALUATION FORM – PHYSICAL (Version 1) Variable length Columns Variable Name





4 45-48 HEIGHT N 1

3 50-52 WEIGHT N 2

3 54-56 BPSYS N 3A

3 58-60 BPDIAS N 3B

3 62-64 HRATE N 4

1 66 VISION N 5

1 68 VISCORR N 6

1 70 VISWCORR N 6A

1 72 HEARING N 7

1 74 HEARAID N 8

1 76 HEARWAID N 8A

Packet F, Form B2: EVALUATION FORM – HACHINSKI ISCHEMIC SCALE (Version 1) Variable length Columns Variable Name





1 45 ABRUPT N 1

1 47 STEPWISE N 2

1 49 SOMATIC N 3

1 51 EMOT N 4

1 53 HXHYPER N 5

1 55 HXSTROKE N 6

1 57 FOCLSYM N 7

1 59 FOCLSIGN N 8

2 61-62 HACHIN N 9

Packet F, Form B3: EVALUATION FORM – UPDRS (Version 1) Variable length Columns Variable Name





1 45 PDNORMAL N 0Z

1 47 SPEECH N 1

1 49 FACEXP N 2

1 51 TRESTFAC N 3A

1 53 TRESTRHD N 3B

1 55 TRESTLHD N 3C

1 57 TRESTRFT N 3D

1 59 TRESTLFT N 3E

1 61 TRACTRHD N 4A

1 63 TRACTLHD N 4B

1 65 RIGDNECK N 5A

1 67 RIGDUPRT N 5B

1 69 RIGDUPLF N 5C

1 71 RIGDLORT N 5D

1 73 RIGDLOLF N 5E

1 75 TAPSRT N 6A

60 77-136 TAPSRTX C 6A1

1 138 TAPSLF N 6B

60 140-199 TAPSLFX C 6B1

1 201 HANDMOVR N 7A

60 203-262 HANDMVRX C 7A1

1 264 HANDMOVL N 7B

60 266-325 HANDMVLX C 7B1

1 327 HANDALTR N 8A

60 329-388 HANDATRX C 8A1

1 390 HANDALTL N 8B

60 392-451 HANDATLX C 8B1

Packet F, Form B3: EVALUATION FORM – UPDRS (Version 1) Variable length Columns Variable Name



1 453 LEGRT N 9A

60 455-514 LEGRTX C 9A1

1 516 LEGLF N 9B

60 518-577 LEGLFX C 9B1

1 579 ARISING N 10

60 581-640 ARISINGX C 10A

1 642 POSTURE N 11

60 644-703 POSTUREX C 11A

1 705 GAIT N 12

60 707-766 GAITX C 12A

1 768 POSSTAB N 13

60 770-829 POSSTABX C 13A

1 831 BRADYKIN N 14

Packet F, Form B4: GLOBAL STAGING – CDR (Version 1) Variable length Columns Variable Name





3 45-47 MEMORY N 1

3 49-51 ORIENT N 2

3 53-55 JUDGMENT N 3

3 57-59 COMMUN N 4

3 61-63 HOMEHOBB N 5

3 65-67 PERSCARE N 6

4 69-72 CDRSUM N 7

3 74-76 CDRGLOB N 8

Packet F, Form B5: BEHAVIORAL ASSESSMENT – NPI-Q (Version 1) Variable length Columns Variable Name





1 45 NPIQINF N 1

60 47-106 NPIQINFX C 1A

1 108 DEL N 2A

1 110 DELSEV N 2B

1 112 HALL N 3A

1 114 HALLSEV N 3B

1 116 AGIT N 4A

1 118 AGITSEV N 4B

1 120 DEPD N 5A

1 122 DEPDSEV N 5B

1 124 ANX N 6A

1 126 ANXSEV N 6B

1 128 ELAT N 7A

1 130 ELATSEV N 7B

1 132 APA N 8A

1 134 APASEV N 8B

1 136 DISN N 9A

1 138 DISNSEV N 9B

1 140 IRR N 10A

1 142 IRRSEV N 10B

1 144 MOT N 11A

1 146 MOTSEV N 11B

1 148 NITE N 12A

1 150 NITESEV N 12B

1 152 APP N 13A

1 154 APPSEV N 13B

Packet F, Form B6: BEHAVIORAL ASSESSMENT – GDS (Version 1) Variable length Columns Variable Name





1 45 NOGDS N 0Z

1 47 SATIS N 1

1 49 DROPACT N 2

1 51 EMPTY N 3

1 53 BORED N 4

1 55 SPIRITS N 5

1 57 AFRAID N 6

1 59 HAPPY N 7

1 61 HELPLESS N 8

1 63 STAYHOME N 9

1 65 MEMPROB N 10

1 67 WONDRFUL N 11

1 69 WRTHLESS N 12

1 71 ENERGY N 13

1 73 HOPELESS N 14

1 75 BETTER N 15

2 77-78 GDS N 16

Packet F, Form B7: FUNCTIONAL ASSESSMENT – FAQ (Version 1) Variable length Columns Variable Name





1 45 BILLS N 1

1 47 TAXES N 2

1 49 SHOPPING N 3

1 51 GAMES N 4

1 53 STOVE N 5

1 55 MEALPREP N 6

1 57 EVENTS N 7

1 59 PAYATTN N 8

1 61 REMDATES N 9

1 63 TRAVEL N 10

Packet F, Form B8: EVALUATION – PHYSICAL/NEUROLOGICAL EXAM FINDINGS (Version 1) Variable length Columns Variable Name





1 45 NORMAL N 1

1 47 FOCLDEF N 2

1 49 GAITDIS N 3

1 51 EYEMOVE N 4

Packet F, Form B9: CLINICIAN JUDGMENT OF SYMPTOMS ONSET (Version 1) Variable length Columns Variable Name





1 45 B9CHG N 0Z

1 47 DECSUB N 1

1 49 DECIN N 2

1 51 DECCLIN N 3A

3 53-55 DECAGE N 3B

1 57 COGMEM N 4A

1 59 COGJUDG N 4B

1 61 COGLANG N 4C

1 63 COGVIS N 4D

1 65 COGATTN N 4E

1 67 COGOTHR N 4F

60 69-128 COGOTHRX C 4F1

2 130-131 COGFRST N 5

60 133-192 COGFRSTX C 5A

2 194-195 COGMODE N 6

60 197-256 COGMODEX C 6A

1 258 BEAPATHY N 7A

1 260 BEDEP N 7B

1 262 BEVHALL N 7C1

1 264 BEAHALL N 7C2

1 266 BEDEL N 7C3

1 268 BEDISIN N 7D

1 270 BEIRRIT N 7E

1 272 BEAGIT N 7F

1 274 BEPERCH N 7G

1 276 BEOTHR N 7H

60 278-337 BEOTHRX C 7H1

Packet F, Form B9: CLINICIAN JUDGMENT OF SYMPTOMS ONSET (Version 1) Variable length Columns Variable Name



2 339-340 BEFRST N 8

60 342-401 BEFRSTX C 8A

2 403-404 BEMODE N 9

60 406-465 BEMODEX C 9A

1 467 MOGAIT N 10A

1 469 MOFALLS N 10B

1 471 MOTREM N 10C

1 473 MOSLOW N 10D

2 475-476 MOFRST N 11

2 478-479 MOMODE N 12

60 481-540 MOMODEX C 12A

1 542 COURSE N 13

1 544 FRSTCHG N 14

Packet F, Form C1: MMSE and NEUROPSYCHOLOGICAL BATTERY (Version 1) Variable length Columns Variable Name





1 45 MMSELOC N 1A

1 47 MMSELAN N 1A1

60 49-108 MMSELANX C 1A2

2 110-111 MMSEORDA N 1B1

2 113-114 MMSEORLO N 1B2

2 116-117 MMSE N 1C

1 119 NPSYCLOC N 2

1 121 NPSYLAN N 2A

60 123-182 NPSYLANX C 2A1

2 184-185 LOGIMO N 3A1

2 187-188 LOGIDAY N 3A2

4 190-193 LOGIYR N 3A3

2 195-196 LOGIPREV N 3B

2 198-199 LOGIMEM N 3C

2 201-202 DIGIF N 4A

2 204-205 DIGIFLEN N 4B

2 207-208 DIGIB N 5A

2 210-211 DIGIBLEN N 5B

2 213-214 ANIMALS N 6A

2 216-217 VEG N 6B

3 219-221 TRAILA N 7A

3 223-225 TRAILB N 7B

2 227-228 WAIS N 8A

2 230-231 MEMUNITS N 9A

2 233-234 MEMTIME N 9B

2 236-237 BOSTON N 10A

1 239 COGSTAT N 11A

Packet F, Form D1: CLINICIAN DIAGNOSIS – COGNITIVE STATUS AND DEMENTIA (Version 1) Variable length Columns Variable Name





1 45 WHODIDDX N 1

1 47 NORMCOG N 2

1 49 DEMENTED N 3

1 51 MCIAMEM N 4A

1 53 MCIAPLUS N 4B

1 55 MCIAPLAN N 4B1

1 57 MCIAPATT N 4B2

1 59 MCIAPEX N 4B3

1 61 MCIAPVIS N 4B4

1 63 MCINON1 N 4C

1 65 MCIN1LAN N 4C1

1 67 MCIN1ATT N 4C2

1 69 MCIN1EX N 4C3

1 71 MCIN1VIS N 4C4

1 73 MCINON2 N 4D

1 75 MCIN2LAN N 4D1

1 77 MCIN2ATT N 4D2

1 79 MCIN2EX N 4D3

1 81 MCIN2VIS N 4D4

1 83 IMPNOMCI N 4E

1 85 PROBAD N 5

1 87 PROBADIF N 5A

1 89 POSSAD N 6

1 91 POSSADIF N 6A

1 93 DLB N 7

1 95 DLBIF N 7A

1 97 VASC N 8




1 99 VASCIF N 8A

1 101 ALCDEM N 9

1 103 ALCDEMIF N 9A

1 105 DEMUN N 10

1 107 DEMUNIF N 10A

1 109 FTD N 11

1 111 FTDIF N 11A

1 113 PPAPH N 12

1 115 PPAPHIF N 12A

1 117 PNAPH N 12A1

1 119 SEMDEMAN N 12A2

1 121 SEMDEMAG N 12A3

1 123 PPAOTHR N 12A4

1 125 PSP N 13

1 127 PSPIF N 13A

1 129 CORT N 14

1 131 CORTIF N 14A

1 133 HUNT N 15

1 135 HUNTIF N 15A

1 137 PRION N 16

1 139 PRIONIF N 16A

1 141 MEDS N 17

1 143 MEDSIF N 17A

1 145 DYSILL N 18

1 147 DYSILLIF N 18A

1 149 DEP N 19

1 151 DEPIF N 19A

1 153 OTHPSY N 20

1 155 OTHPSYIF N 20A

1 157 DOWNS N 21

1 159 DOWNSIF N 21A

1 161 PARK N 22

1 163 PARKIF N 22A

1 165 STROKE N 23

1 167 STROKIF N 23A

1 169 HYCEPH N 24




1 171 HYCEPHIF N 24A

1 173 BRNINJ N 25

1 175 BRNINJIF N 25A

1 177 NEOP N 26

1 179 NEOPIF N 26A

1 181 COGOTH N 27

1 183 COGOTHIF N 27A

60 185-244 COGOTHX C 27B

Packet F, Form E1: IMAGING/LABS (Version 1) Variable length Columns Variable Name





1 45 CTFLM N 1A

1 47 CTDIG N 1B

1 49 MRI1FLM N 2A

1 51 MRI1DIG N 2B

1 53 MRI2FLM N 3A

1 55 MRI2DIG N 3B

1 57 MRI3FLM N 4A

1 59 MRI3DIG N 4B

1 61 MRISPFLM N 5A

1 63 MRISPDIG N 5B

1 65 SPECTFLM N 6A

1 67 SPECTDIG N 6B

1 69 PETFLM N 7A

1 71 PETDIG N 7B

1 73 DNA N 8

1 75 CSFANTEM N 9

1 77 SERUM N 10

1 79 APOE N 11

uds follow-up visit packet, v1.2, 2006sep. · nacc uds follow-up visit packet (version 1.2, sep....

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